In July of last year I had a cluster of 'real' migraines. For some years I've had clusters of auras without other symptoms, but these came with light sensitivity, nausea and headaches as well. I've only had a handful of those in my life and each time, as with the first of these, I haven't recognised what they were as they happen so rarely.
Over time the headaches stopped, but I developed other visual weirdnesses and the nausea became near-constant - never gone, although sometimes better and sometimes worse. In recent months I've developed huge fatigue, too. Issues with swallowing that I had a few years' back have returned, and haven't gone away with a medication increase.